Nurses Intent on Being Part of Debate

Nurses march in Upper Senate Park last week during a national day of action. Nurses say they can help bring health care costs under control by playing a more prominent role in the health care system.

This bill would allow a nurse practitioner to be a team leader, Artz said. Thats the piece that would be most exciting. ... We are really grateful for Congresswoman Schwartzs vision and leadership, and were hoping that that model can move forward in health care reform.

Schwartz said nurses have an essential role in health care reform.

As we look at health care reform, we are focused on three aspects: containing costs, improving quality and expanding access, Schwartz said. We know that one of the best ways to do that is to improve primary care and management of people who have chronic disease. ... Nurses working with physicians and nurse practitioners who often see patients directly, both have very important roles, and that was acknowledged in the legislation.

Michael Lighty, director of public policy for the California Nurses Association-
National Nurses Organizing Committee, said his labor group is making a top priority H.R. 676, a bill sponsored by Rep. John Conyers (D-Mich.) that would provide for comprehensive health insurance coverage for all U.S. residents.

Lighty said his nurses work at patients bedsides and see the dysfunction of the health care system every day.

The only way to guarantee a single standard of care  a system where you dont have bronze care for one type of patient and gold for another  we need everybody in one system, Lighty said. We dont talk about getting everyone covered. We talk about everyone getting the care they need.

Lighty said the Senate Finance Committee hasnt given us that seat on the Senate side, but the group is pursuing inroads on the House side, including holding a meeting with Majority Leader Steny Hoyer (D-Md.).

It is difficult, Lighty said. There are deep-pocket stakeholders that represent industries that have spent billions in lobbying.

Other nurses groups are focused on more specific aspects of health reform legislation.

Jan Towers, director of health policy for the American Academy of Nurse Practitioners, said that when Members are drafting health care reform, her group wants to make sure that nurse practitioners, not just physicians, are actually written into the law as primary care providers.

Generally speaking, the physician community has been very supportive, but the AMA has a problem with anybody thats not a physician, she said.

In a statement, the American Medical Association noted that doctors medical training lasts 11-15 years or more after high school, and that patients deserve the highest quality care provided by health care professionals who are appropriately educated.

Nurse practitioners are inclined to practice preventive care and management of chronic care, and can often do so at a cheaper cost, Towers said. We are more cost-effective, she said, pointing to studies that show a positive impact on patient outcomes.

Some of the nursing models are the best models for managing chronic disease, she said.

Still, conflicts, especially with some doctors groups, abound.

Its always a challenge, Ford-Roegner said. Advanced practice nurses are not interested in becoming doctors. They want to be able to practice to the full scope of their abilities.